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Agri. 2020 Jan;32(1):31-37. doi: 10.14744/agri.2019.15921.

Distal approach for percutaneous radiofrequency thermocoagulation of lumbar medial branches in patients with lumbar facet arthropathy: A retrospective analysis.

Author information

1
Department of Algologia, Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Turkey.
2
Department of Anesthesia, Şehitkamil State Hospital, Gaziantep, Turkey.

Abstract

OBJECTIVES:

Lumbar facet (zygapophysial) arthropathy is a common cause of chronic lower back pain, and percutaneous radiofrequency denervation of the facet joints appears to be an effective treatment that yields long-term improvement. A technique utilising a distal approach to place the needle parallel to the medial branch has recently come into common use. In the present study, a technique incorporating a distal approach and an A-P fluoroscopic view was investigated.

METHODS:

In this study, clinical charts of 164 patients with lumbar facet syndrome who had undergone RFTC (radiofrequency thermocoagulation) of facet-joint medial branches were retrospectively evaluated. The success rate of percutaneous radiofrequency thermocoagulation of facet-joint medial branches performed utilising a distal approach with an A-P view was evaluated. NRS (numeric rank score) pain scores and subjective patient-reported global responses were measured.

RESULTS:

Of the patients, responses were rated as excellent by 46 (28.0%), good by 67 (40.8%), fair by 21 (12.8%) and poor by 30 (18.2%). The median duration of pain relief was 7.3 months. In the 113 patients who reported excellent or good responses, the median duration of pain relief was 10.2 months.

CONCLUSION:

Radiofrequency thermocoagulation for facet arthropathy is a safe and effective treatment option that is well-tolerated. We suggest that a distal approach with an A-P view for facet radiofrequency thermocoagulation is a viable alternative to other approaches.

PMID:
32030696
DOI:
10.14744/agri.2019.15921
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